very interesting question

Is cervical-cancer vaccine worth a shot?
By Amy Wilson
McClatchy Newspapers
(MCT)

What's a mother to do?

Bombarded by commercials that urge her and everyone around her to "tell someone," she pays attention to the news that a vaccine has been engineered - and approved - that will protect women against the human papillomavirus, which causes 75 percent of all cervical cancer.

Furthermore, studies have found the vaccine to be almost 100 percent effective in preventing precancers of the cervix, vulva and vagina and genital warts.

But should she vaccinate HER daughters?

The virus, also known as HPV, can be fatal. It is the most prevalent sexually transmitted disease in the world. The cancer it can cause is second only to breast cancer in its ability to kill women.

In June, the Food and Drug Administration approved the manufacture of Gardasil, Merck's version of the vaccine. The vaccine itself was developed by Albert Jenson and Shin-Je Ghim, researchers now at the University of Louisville.

The decision whether to vaccinate is complicated by its price, $360, and that insurance coverage is being worked out. (Some insurers are waiting for the CDC to formally adopt recommendations from its Advisory Committee on Immunization Practices, expected in November.)

Then there is the debate about the wisdom of any vaccination. So, yes, all parents are cautious. Parents of teenage daughters have a lot of deciding to do.

We turned to the experts for advice. Here is what they had to say:

The Food and Drug Administration: The agency recommends the vaccine for all girls and women ages 9 to 26.

Centers for Disease Control and Prevention: Its immunization committee has recommended that the CDC endorse routine vaccinations for girls 11 to 12 years old, before sexual activity.

Dr. Albert "Ben" Jenson, a researcher of tumor immunobiology at the University of Louisville James Graham Brown Cancer Center and part of the original team of scientists at Georgetown University that invented the HPVvaccine and holds the patent on it: "I can't think of a reason not to (get the vaccine). The adverse reactions are very small. It's the first vaccination to prevent cancer. My three daughters - ages 42, 40 and 38 - are going to get it. I think every woman should have it. Maybe they don't have it (HPV) now, but they could get it if their partner, no matter how committed, has (pause) flaws and brings the virus into the relationship. I think men should have it too - to protect women."

(The vaccine is being tested on men, he said, but most of the initial trials were done on women because they can die of the diseases associated with HPV.)

Dr. W. David Hager, a prominent Lexington gynecologist and conservative Christian voice on women's health and sexuality, a Bush-appointed member of the FDA's Advisory Committee for Reproductive Health Drugs and on Merck's Ob/Gyn Advisory Board for Immunization: "I have worked to help other organizations understand (Merck's Gardasil) and the need for it.

"(After) the FDA approved the product, the Advisory Committee for Immunization Practices at the CDC made recommendations for use in 9- to 26-year-old women with the principal age of immunization being 11 to 12 years of age. We do not have sufficient data in men to warrant approval at this time, although the studies to evaluate this are in process.

"Merck has been good about not encouraging sexual activity in their marketing strategy. We continue to say that girls should remain abstinent as the best way to prevent sexually transmitted infections and non-marital pregnancy. However, the latest data from the Youth Risk Behavior Surveillance Survey indicate that almost 7 percent of kids have initiated sexual intercourse by 13 years of age. Thus, it is important to immunize before sexual activity begins. Even if a young lady remains abstinent until marriage but marries a guy who has been sexually active, he could bring HPV into the relationship. So I strongly recommend encouraging abstinence but giving the vaccine at 11 to 12 years of age."

Dr. Susan Modesitt, associate professor of gynecologic oncology, University of Virginia: "I personally would recommend the vaccine early (age 12 or so) and am hopeful that it will be made mandatory."